The purpose of this meta-analysis was to evaluate the survival rate of oral implants and investigate potential risk factors for implant therapy in HNN patients. An extensive search was conducted in four electronic databases from their inception to April 2024. Study selection, data extraction, and risk of bias assessment were performed independently by two reviewers. Survival rates were calculated and analyzed using R software. Meta-analyses were performed using fixed-effects or random-effects models based on heterogeneity assessment (random-effects model used when I² > 50% and/or Q-test P < 0.10) to calculate the risk ratio (RR) for implant survival. although retrospectively registered in Prospective Register of Systematic Reviews (PROSPERO), the study protocol was developed prior to data synthesis and adhered to the PRISMA guidelines. Forty-two studies (2,448 patients, 10,164 implants) with heterogeneous follow-up durations (range: 1–12 years) were included. The pooled aggregate implant survival rate was 88% (95% CI: 85–90%), derived from single-arm analyses and representing crude survival proportions rather than time-specific estimates. Significant heterogeneity was observed among studies (I² = 94.9%; P < 0.0001). The meta-analyses revealed the following results: (1) Implant survival was significantly lower in irradiated bone compared to non-irradiated bone (18 studies, RR for survival = 0.95; 95% CI = 0.91–0.99; P = 0.03). (2) Implant survival was significantly lower in grafted bone compared to native bone (15 studies, RR for survival = 0.92; 95% CI = 0.88–0.97; P = 0.0008). (3) implant survival rates were significantly higher in patients who underwent hyperbaric oxygen therapy (HBO) compared to those who did not (5 studies, RR for survival = 1.47; 95% CI = 1.06–2.03; P = 0.02). (4) implants placed in the anterior region had significantly higher survival compared to those in the posterior region (6 studies, RR for survival = 1.07; 95% CI = 1.02–1.12; P = 0.008). The aggregated evidence suggests an overall implant survival rate of 88% (95% CI: 85–90%), though with substantial heterogeneity (I² = 94.9%). Radiation therapy and bone grafting were associated with statistically significant but modest reductions in implant survival. Conversely, implant placement in the anterior region and adjunctive HBO showed potential survival benefits. HBO showed potential benefit (RR = 1.47), but this finding was based on only five studies with considerable heterogeneity (I² = 91%) and requires confirmation in larger and randomized trials. The investigation was retrospectively registered in the International PROSPERO under the application identifier CRD42024604320.
Liu et al. (Wed,) studied this question.